OBJECTIVES: To explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon data from multiple psychological questionnaires, and profile subgroups on data from multiple dimensions. METHODS: Psychological questionnaires considered as indicator variables entered into latent class analysis included: Depression, Anxiety, Stress scales, Thought Suppression and Behavioural Endurance subscales (Avoidance Endurance questionnaire), Chronic Pain Acceptance Questionnaire (short-form), Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, and Fear-Avoidance Beliefs Questionnaire. Multidimensional profiling of derived clusters included: demographics, pain characteristics, pain responses to movement, behaviors associated with pain, body perception, pain sensitivity, and health and lifestyle factors. RESULTS: Three clusters were derived. Cluster 1 (23.5%) was characterized by low Cognitive and Affective Questionnaire scores, with the exception of fear-avoidance beliefs. Cluster 2 (58.8%) was characterized by relatively elevated thought suppression, catastrophizing, and fear-avoidance beliefs, but lower pain self-efficacy, depression, anxiety, and stress. Cluster 3 (17.7%) had the highest scores across cognitive and affective questionnaires.Cluster 1 reported significantly lower pain intensity and bothersomeness than other clusters. Disability, stressful life events, and low back region perceptual distortion increased progressively from cluster 1 to cluster 3, whereas mindfulness progressively decreased. Clusters 2 and 3 had more people with an increase in pain following repeated forward and backward spinal bending, and more people with increasing pain following bending, than cluster 1. Cluster 3 had significantly greater lumbar pressure pain sensitivity, more undiagnosed comorbid symptoms, and more widespread pain than other clusters. DISCUSSION: Clinical implications relating to presentations of each cluster are postulated.
OBJECTIVES: To explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon data from multiple psychological questionnaires, and profile subgroups on data from multiple dimensions. METHODS: Psychological questionnaires considered as indicator variables entered into latent class analysis included: Depression, Anxiety, Stress scales, Thought Suppression and Behavioural Endurance subscales (Avoidance Endurance questionnaire), Chronic Pain Acceptance Questionnaire (short-form), Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, and Fear-Avoidance Beliefs Questionnaire. Multidimensional profiling of derived clusters included: demographics, pain characteristics, pain responses to movement, behaviors associated with pain, body perception, pain sensitivity, and health and lifestyle factors. RESULTS: Three clusters were derived. Cluster 1 (23.5%) was characterized by low Cognitive and Affective Questionnaire scores, with the exception of fear-avoidance beliefs. Cluster 2 (58.8%) was characterized by relatively elevated thought suppression, catastrophizing, and fear-avoidance beliefs, but lower pain self-efficacy, depression, anxiety, and stress. Cluster 3 (17.7%) had the highest scores across cognitive and affective questionnaires.Cluster 1 reported significantly lower pain intensity and bothersomeness than other clusters. Disability, stressful life events, and low back region perceptual distortion increased progressively from cluster 1 to cluster 3, whereas mindfulness progressively decreased. Clusters 2 and 3 had more people with an increase in pain following repeated forward and backward spinal bending, and more people with increasing pain following bending, than cluster 1. Cluster 3 had significantly greater lumbar pressure pain sensitivity, more undiagnosed comorbid symptoms, and more widespread pain than other clusters. DISCUSSION: Clinical implications relating to presentations of each cluster are postulated.
Authors: Alison M Thorpe; Peter B O'Sullivan; Tim Mitchell; Mark Hurworth; Jonathan Spencer; Grant Booth; Sven Goebel; Paul Khoo; Aaron Tay; Anne Smith Journal: Clin Orthop Relat Res Date: 2018-10 Impact factor: 4.176
Authors: Chung Jung Mun; Mary C Davis; Ivan R Molton; Paul Karoly; Hye Won Suk; Dawn M Ehde; Howard Tennen; Robert D Kerns; Mark P Jensen Journal: Rehabil Psychol Date: 2019-01-28
Authors: Sheila M Gaynor; Andrey Bortsov; Eric Bair; Roger B Fillingim; Joel D Greenspan; Richard Ohrbach; Luda Diatchenko; Andrea Nackley; Inna E Tchivileva; William Whitehead; Aurelio A Alonso; Thomas E Buchheit; Richard L Boortz-Marx; Wolfgang Liedtke; Jongbae J Park; William Maixner; Shad B Smith Journal: Pain Date: 2021-05-01 Impact factor: 7.926
Authors: Jae Yun Kim; Jae Hang Shim; Sung Jun Hong; Jong Yeun Yang; Hey Ran Choi; Yun Hee Lim; Ho Sik Moon; Jaemoon Lee; Jae Hun Kim Journal: Korean J Pain Date: 2017-03-31
Authors: Rogelio A Coronado; Jordan A Bley; Laura J Huston; Jacquelyn S Pennings; Hiral Master; Emily K Reinke; Mackenzie L Bird; Erica A Scaramuzza; Christine M Haug; Shannon L Mathis; Susan W Vanston; Charles L Cox; Kurt P Spindler; Kristin R Archer Journal: Phys Ther Sport Date: 2021-06-02 Impact factor: 2.920